Electrophysiologic Effects of Salbutamol, a β<sub>2</sub>‐Selective Agonist

Insulander, Per; Juhlin‐Dannfelt, A.; Freyschuss, U.; Vallin, Hans

doi:10.1046/j.1540-8167.2004.03105.x

Cited by 25 publications

(25 citation statements)

References 40 publications

(80 reference statements)

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“…In the control group of horses, the low cardiac output was compensated for by an increase in systemic arterial blood pressure, possibly caused by an increased systemic vascular resistance. We did not record any decrease in systemic arterial blood pressure in our experimental horses following salbutamol administration which was however observed in human patients in studies conducted by Wong et al (1990), Bennet et al (1994) and Insulander et al (2004). In a study on horses, Lee et al (1998) also recorded a short-term decrease in systemic arterial blood pressure following intravenous administration of clenbuterol which lasted on average for 5 min.…”

Section: Discussioncontrasting

confidence: 48%

“…An increase in the inotropic state following intravenous salbutamol administration was also recorded by Insulander et al (2004). The chronotropic action of salbutamol is derived from direct stimulation of β 2 receptors in the heart and from the baroreceptor reflex that results from peripheral vasodilatation caused by the influence on β 2 vascular receptors (Insulander et al, 2004). Studies in human medicine (Wong et al, 1990;Bennet et al, 1994;Insulander et al, 2004) describe the action of inhalation or intravenous salbutamol administration similarly: heart rate increase, peripheral vasodilatation and a decrease in diastolic arterial blood pressure caused by the above mentioned mechanisms.…”

Section: Discussionmentioning

confidence: 97%

“…The inotropic mechanism for an increase in cardiac output following inhalation salbutamol administration is described by Spiekerkoetter et al (2002) in human patients with primary pulmonary hypertension. An increase in the inotropic state following intravenous salbutamol administration was also recorded by Insulander et al (2004). The chronotropic action of salbutamol is derived from direct stimulation of β 2 receptors in the heart and from the baroreceptor reflex that results from peripheral vasodilatation caused by the influence on β 2 vascular receptors (Insulander et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

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The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

Patschova¹,

Kabeš²,

Krisová³

2010

Vet. Med. - Czech

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ABSTRACT:This research aimed to determine the effect of aerosolized salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance in healthy horses during general anaesthesia. Six healthy Thoroughbreds (body weight range 471-587 kg) underwent two general anaesthesias in dorsal recumbency with and without aerosolized salbutamol administration in randomized order with a one month washout period. The anaesthesia was induced by 1.1 mg/kg of xylazine, 0.02 mg/kg of diazepam and 2.2 mg/kg of ketamine, maintained with isoflurane in oxygen and air and horses were mechanically ventilated. Measurement of arterial and pulmonary arterial blood pressures, cardiac output and arterial and mixed venous blood gas analysis was carried out. Spirometry was performed using a Horse-lite. After achieving a steady state, baseline (T 0 ) values of cardiac output, systemic and pulmonary arterial blood pressures, heart rate, dynamic compliance, airway resistance and arterial and mixed venous blood gas values and pH were recorded in both groups. In the S-group (salbutamol), 2 µg/kg of aerosolized salbutamol were administered synchronously with inspirium into the tracheal tube. In both groups data were recorded at 15, 30, 45 and 60 min (T 15 , T 30 , T 45 , T 60 ) after the baseline. PaO 2 /FiO 2 ratio, oxygen consumption (VO 2 ), oxygen delivery (DO 2 ), pulmonary shunt values were calculated. Data were tested for normality and compared within each group: T 0 value with T 15 , T 30 , T 45 , T 60 values using Wilcoxon's test with Bonferoni correction (significance level 0.0125). For each time point, comparisons were made between the S-and C-groups (control) using Wilcoxon's test. In the S-group, there was a significant increase in values (mean ± SD) of cardiac output (l/min), T 0 (38 ± 7), a peak at T 15 (64 ± 25.5), significantly higher values persisted throughout the period of anaesthesia; heart rate (beats/min), T 0 (32 ± 2), T 15 (40 ± 6), T 30 (38 ± 5); DO 2 (l/min), T 0 (5.8 ± 0.8), a peak at T 15 (9.6 ± 3.2), significantly higher values persisted until the end of anaesthesia and VO 2 (l/min), T 0 (1.1 ± 0.5), T 30 (1.6 ± 0.7) and T 45 (1.8 ± 0.5). In the C-group, there was a significant decrease in values of PaO 2 /FiO 2 ratio from T 0 (176 ± 67) to a minimum at T 60 (114 ± 36) and in DO 2 from T 0 (6 ± 2.3) to a minimum at T 60 (4.3 ± 1.2). A comparison of the S-and C-groups did not reveal any difference in the baseline data. Subsequently, significantly higher values of cardiac output, heart rate, DO 2 , and the PaO 2 /FiO 2 ratio were found in the S-group compared to the C-group. Pulmonary arterial blood pressure was significantly lower in the S-group. Aerosolized salbutamol administration in healthy horses during general anaesthesia caused hemodynamic changes which resulted in an elevation of oxygen delivery. It can have a positive effect on arterial oxygenation, but the effect varies between individuals.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

Patschova¹,

Kabeš²,

Krisová³

2010

Vet. Med. - Czech

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“…Multiple studies on human subjects have shown that salbutamol via its beta-2 action significantly enhances atrioventricular nodal conduction and reduces atrioventricular nodal, atrial, and ventricular refractoriness. 18,19 Epidemiological studies have shown that patients with COPD and asthma treated with oral steroids were at an increased risk of developing AF even after controlling for a few factors of disease severity. 20 van der Hooft et al 21 also found a higher incidence of AF among patients requiring high dose oral steroids regardless of the etiology (rheumatic, allergic, or malignant hematological diseases).…”

Section: Discussionmentioning

confidence: 99%

Atrial Flutter Versus Atrial Fibrillation in a General Population: Differences in Comorbidities Associated With Their Respective Onset

Mareedu¹,

Abdalrahman²,

Dharmashankar³

et al. 2009

Clinical Medicine & Research

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“…Such doses of salbutamol are commonly given by nebulizer during acute asthmatic attacks. It has been demonstrated that intravenous salbutamol resulted in significant discordant electrophysiological effects on ventricular conduction, which slowed, and the refractoriness of the ventricular myocardium, which shortened and QT dispersion was increased (9).…”

Section: Introductionmentioning

confidence: 99%

Effects of salbutamol given by metered-dose inhaler on dispersion of ventricular repolarization

Polat

Saz²,

Nursoy³

2011

Anadolu Kardiyol Derg

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ÖZETAmaç: Daha önceki çalışmalarda salbutamolün astımlı hastalarda QT dispersiyonunu (QTd) arttırdığı ve bununda kardiyak aritmi ile ilişkisi gös-terilmiştir. Salbutamolün kardiyak etkileri verilen dozla ilişkilidir ve akut astım atağı sırasında ölçülü doz inhalerle (ÖDİ) verilen doz miktarı nebulizatörle verilen dozların genellikle altındadır. Bu prospektif kohort çalışmada orta şiddette akut astım atağı sırasında ÖDİ ile verilen salbutamolün QTd üzerine etkisi değerlendirilmiştir. Yöntemler: Spirometrik manevraları yapabilecek ve ÖDİ ile salbutamol alabilecek 5-15 yaş arası 32 hasta çalışmaya dahil edildi. Salbutamol doz başına 50 μg/kg olacak şekilde 15-20 dakika arayla üç dozda verildi. Hastaların klinik durumu, spirometrik parametreler ve standart elektrokardiyogramdan QT ölçümleri, salbutamol verilmeden önce ve üçüncü dozdan 15 dakika sonra değerlendirildi. Sürekli değişkenlere bağlı olarak, tedavi öncesi ve sonrası ilişki eşleştirilmiş Student's t-testi ile değerlendirildi. Bulgular: Tedavi tüm hastalarda iyi tolere edildi, tedavi sonrası pulmoner indeks puanlarında ve spirometrik parametrelerde anlamlı düzelme izlendi. Tedavi öncesi ve sonrası QTd (30.4±5.6 msn; 33.7±6.2 msn, p=0.086) ve düzeltilmiş QTd (38.8±6.4 msn; 40.7±7.7 msn, p=0.18) değerlerinde farklılık saptanmadı. Sonuç: Çocuklarda orta şiddette akut astım atağında ölçülü doz inhalerle verilen salbutamol ile nebulizatörle verilen miktara göre, oldukça düşük dozlarda tatmin edici klinik düzelme sağlanmaktadır ve ventrikül repolarizasyonu etkilenmemektedir. (Anadolu Kardiyol Derg 2011; 11: 232-6) Anahtar kelimeler: Salbutamol, ölçülü doz inhaler, QT dispersiyonu, orta şiddette astım atağı ABSTRACT Objective: Salbutamol has previously been shown to increase the QT dispersion (QTd), which may be associated with high risk of cardiac arrhythmia in asthmatics. Cardiac effects of salbutamol occur in dose-related manner and salbutamol dose given by metered-dose inhaler (MDI) during acute asthma attack is commonly lower than the dose given by nebulizer. This prospective cohort study aimed to assess the effect of salbutamol given by MDI on QTd in the course of moderate acute asthma attack. Methods: Thirty-two children, between 5-15 years of age, who were able to perform spirometric maneuvers and salbutamol administration by MDI through the spacer, were enrolled. Salbutamol was administered at a dose of 50 μg/kg three times at 15-20 minute intervals. Clinical features, spirometric parameters and QT measurements from the standard electrocardiograms were studied at baseline and 15 minute after the third inhalation of salbutamol. The relation between the continuous variables was evaluated by using paired Student's t-test. Results: Overall, treatments were well-tolerated, significant improvement of pulmonary index scores and spirometric parameters were observed after treatment. No significant difference was observed between the pre and post-treatment values in QTd (30.4±5.6 ms; 33.7±6.2 ms, p=0.086) and corrected QTd (38.8±6.4 ms; 40.7±7.7 ms, p=0.18). Conclus...

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Electrophysiologic Effects of Salbutamol, a β₂‐Selective Agonist

Cited by 25 publications

References 40 publications

The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

Atrial Flutter Versus Atrial Fibrillation in a General Population: Differences in Comorbidities Associated With Their Respective Onset

Effects of salbutamol given by metered-dose inhaler on dispersion of ventricular repolarization

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Electrophysiologic Effects of Salbutamol, a β2‐Selective Agonist

Cited by 25 publications

References 40 publications

The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

Atrial Flutter Versus Atrial Fibrillation in a General Population: Differences in Comorbidities Associated With Their Respective Onset

Effects of salbutamol given by metered-dose inhaler on dispersion of ventricular repolarization

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Electrophysiologic Effects of Salbutamol, a β₂‐Selective Agonist